Pharmacy Benefits / Insurance Claims Specialist (Medtech)

TL;DR

Pharmacy Benefits / Insurance Claims Specialist (Medtech): Processing and triaging pharmacy insurance claims to ensure patient coverage and accessibility with an accent on compliance and data accuracy. Focus on resolving third-party claim rejections and collaborating cross-functionally to streamline the prescription supply chain.

Location: Fully on-site in Robinson Township, Pittsburgh, PA

Company

A fast-growing healthcare technology company building products to make prescriptions more accessible and affordable for everyone.

What you will do

• Process pharmacy claims accurately and timely to meet client expectations.
• Triage rejected pharmacy insurance claims to ascertain patient pharmacy benefits coverage.
• Maintain strict compliance with patient assistance program guidelines and corporate policies.
• Document data discovery and research findings according to standard operating procedures.
• Work cross-functionally with management, the Missouri-based pharmacy, compliance, and engineering teams.
• Ensure the total confidentiality of patient and proprietary information.

Requirements

• High school diploma or GED required; Bachelor’s degree strongly preferred.
• At least one year of pharmacy experience with a focus on resolving third-party claims.
• Professional background in the healthcare industry with claims experience.
• Strong verbal and written communication skills and attention to detail.
• Technical aptitude and the ability to learn complex new software.
• Must be based in or able to work on-site in Pittsburgh, PA.

Culture & Benefits

• Comprehensive medical, dental, and vision insurance plans.
• 401(k) retirement plan.
• Daily snack stipend for the onsite marketplace.
• Pre-tax transit benefits and free onsite parking.
• Free shuttle service.